Effect of Physician Participation in a Multi-element Health Information and Data Exchange Program on Chronic Illness Medication Adherence.

BACKGROUND: The Primary Care Information Project (PCIP) includes a network of more than 10,000 physicians across New York City focusing on improving the quality of patient care through the use of health information technology and data exchange. METHODS: We assessed adherence, defined as the percentage with a medication possession ratio (MPR) ≥80%, across 2 time periods for union members whose primary care providers participated in the PCIP compared with those whose providers did not participate. Using prescription claims data from 2008 and 2011, the MPR was calculated for disease-specific categories of drugs among patients with diabetes, hypertension, and both conditions. RESULTS: Greater improvements in the number of adherent members were observed for the PCIP patients with diabetes who were taking diabetes-specific medications (odds ratio [OR], 2.03; 95% confidence interval [CI], 1.08-3.83 for PCIP, versus OR, 1.14; 95% CI, 0.81-1.60 for non-PCIP) and patients with diabetes who are taking lipid-controlling medications (OR, 1.64; 95% CI, 0.73-3.65 for PCIP versus OR, 0.85; 95% CI, 0.55-1.32 for non-PCIP). However, the magnitude and significance of these associations were diminished when practices providing reduced prescription co-pays were excluded from the analyses. CONCLUSION: Access to primary care providers participating in a public health initiative was associated with some improvement in medication adherence. However, reducing prescription co-pays may be a stronger factor for higher medication adherence among union members.

Early assessment of health care utilization among a workforce population with access to primary care practices with electronic health records.

This study assesses the health care costs and utilization among labor union members from 2008 to 2010 and compares whether members accessing primary care providers participating in a public health city program, the Primary Care Information Project (PCIP), had different health care usage or cost patterns. Using claims data, the number of hospital inpatient services utilized decreased by 16 per 100 members among those with chronic conditions accessing PCIP providers, whereas members seeing non-PCIP providers increased by 15 per 100 members. Access to providers participating in a population health initiative was associated with lower utilization of inpatient services and overall costs.